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What is elderberry? Hippocrates' "medicine chest"

Elderberry is one of the most commonly used medicinal plants in the world and has been used in traditional medicine for thousands of years. Native Americans were known to use it to treat infections, while the ancient Egyptians used it to heal burns and improve their complexions. It has even been traced back to Hippocrates, the ancient Greek known as the “father of medicine,” who described the plant as his “medicine chest” because of the wide array of health concerns it seemed to cure. Even today, it is still used in folk medicine across many parts of Europe. 

The benefits of the elder plant include improving sinus infections, nerve pain, inflammation, allergies and constipation. When used within the first 48 hours of onset of cold or flu symptoms, elderberry may even help relieve and shorten the duration of these symptoms. Additionally, it may also help lower blood sugar, improve heart health, support healthy skin and act as a natural diuretic.

Elderberry, or elder, refers to many different species of the Sambucus tree, which is a flowering plant that belongs to the Adoxaceae family. 

The European elder, also known as Sambucus nigra or black elder, is the most common tree from this family and the species most often used in elderberry supplements.

Elderberries are the dark purple fruit of the elderberry shrub. The berries and flowers of the elder plant are edible and are used as medicine, however, elderberries have to be cooked before they are consumed. In their uncooked form, elderberries are toxic and can cause diarrhoea, vomiting and nausea.

What does elderberry contain? 

  • Vitamin C: Elderberries contain between 6-35mg of vitamin C per 100g of fruit, making up more than half of your recommended daily dietary vitamin C intake to help support your immune system

  • Dietary fibre: There is 7g of fibre per 100g of fresh elderberries. This is over one-quarter of the recommended daily intake required to support healthy digestion and bowel regularity.  

  • Phenolic acids: These are powerful antioxidant compounds which can help clear the body of free radicals, preventing cell damage from oxidative stress. 

  • Flavonols: Another source of antioxidants that can help prevent cell damage, elderberries contain the antioxidant flavonols: quercetin, kaempferol and isorhamnetin. 

  • Anthocyanins: Anthocyanins are compounds that give the elderberry fruit its deep pigment. The dark black-purple colour of these berries suggest a high concentration of anthocyanins, making them strong antioxidants with anti-inflammatory and immune-suppprting effects. 

Elderberry benefits

Elderberry and immune support 

The most well-known elderberry benefit is its immune-supporting properties (1).

Elderberries are very rich in flavonoids, especially the antioxidant anthocyanins, which are responsible for their deep purple, almost black, colour. These powerful antioxidants work to keep our immune system strong and resilient. Anthocyanins in elderberries have been shown to boost the production of cytokines, proteins that act as messengers within the immune system, therefore enhancing our body’s immune response. Cytokines play a vital role in the immune system’s response to disease.

Elderberry helps with cold & flu symptoms 

Elderberry is most commonly used for the treatment of colds and flus around the world today. 

A study from 2016 showed that among long-haul air travellers, those who used elderberry supplementation from 10 days before and five days after their flight were able to reduce cold duration and symptoms by an average of two days. They were also shown to have less severe colds (2).

Several studies have also found that a significant elderberry benefit is its ability to reduce the severity and length of flu symptoms as well, specifically the flavonoids in the extract which bind to the human influenza virus. Elderberry has also been shown to reduce the severity and duration of flu symptoms by an average of four days if taken within the first 48 hours of the onset of symptoms. 

It is suggested that elderberry extract could help prevent influenza infection by stimulating an immune response. However, what elderberry did not appear to do was reduce the risk of getting a cold (3).

Elderberry is high in antioxidants 

Antioxidants are natural compounds found in food, which include some vitamins, phenolic acids and flavonoids. During regular metabolism, our bodies produce unstable molecules called free radicals which can accumulate and cause oxidative stress in the body. This can lead to the development of some chronic diseases such as cardiovascular diseases, diabetes and neurodegenerative diseases. 

Antioxidants could prevent or slow damage to cells caused by free radicals by removing these reactive molecules, therefore helping to reduce inflammation and oxidative tissue damage, and prevent chronic disease. 

The flowers and fruits of the elderberry plant are excellent sources of antioxidants, including the powerful anthocyanins. Anthocyanin is a type of natural plant pigment found in elderberries that has been shown to have anti-inflammatory and antioxidant properties (4).

Elderberry supports heart health 

Although studies have found mixed results, some research suggests that elderberry extract may have positive effects on some markers of heart and blood vessel health, therefore improving heart health. 

One animal study showed that anthocyanin-rich black elderberry extract helped reduce cholesterol levels and improved HDL “bad cholesterol” function. This may be due to their anthocyanins content, which are polyphenols that have shown to have antioxidant and anti-inflammatory activities (5)

Elderberry supplementation may also have beneficial effects on high blood pressure by reducing arterial pressure, as well as reducing the amount of uric acid in the blood. As high levels of uric acid can contribute to high blood pressure, reducing it can have a positive effect on heart health (6).

Elderberry can lower blood sugar levels  

Both the elderberry and the flower have traditionally been used in the treatment of diabetes. Research has shown that extracts of elderflower stimulate glucose metabolism and insulin secretion, which could potentially help lower blood sugar levels (7).

Elderberry extract has also been shown to significantly increase glucose transport, glucose oxidation and gluconeogenesis without any added insulin. Glycogenesis is the process by which excess sugar is cleared out of the bloodstream and into your muscles and liver to help maintain normal blood sugar. In addition, elder flowers have been shown to inhibit the enzyme α-glucosidase, which may help lower blood sugar levels.

Elderberry can support digestion 

Some research suggests that elderberry tea can benefit constipation and help support regularity and digestive health. This may be due to a specific compound known as anthraquinone, which is found in elderberries and other plants, including rhubarb and senna, that could act as an effective natural laxative for the treatment of constipation. Anthraquinone inhibits the absorption of water in the intestines, which increases the intestinal pressure, stimulating muscle contractions to promote clearance of the bowel (8).

Elderberry may help ease allergies 

As well as using elderberry supplements for colds and flus, it has also been shown to be an effective herbal allergy remedy. Since allergies involve inflammation as well as an overreaction of the immune system, the herb’s ability to support immune function and inflammation levels can help provide allergy symptom relief in some people (9).

Elderberry acts as a natural diuretic 

A diuretic is a substance that promotes the production of urine. Diuretics are used when the body retains too much fluid, which is a common problem in older adults. Due to elderberry’s ability to act as a natural diuretic, it has been shown to promote both urination and bowel movements to help protect against fluid retention (10).

Elderberry has pain-relieving qualities 

Anthocyanins, which are abundant in elderberries, are known to reduce inflammation. They do this by inhibiting the production of nitric oxide from the body's immune cells. Nitric oxide functions as a signalling molecule that triggers inflammation in response to injury or disease. By tempering this response, pain and swelling may be relieved.

Elderberry: Potential risks & side effects 

Despite the many benefits of elderberry, there are some side effects of elderberry to consider. 

Ripe, cooked berries from most of the Sambucus species are edible. However, you should not consume raw or unripe berries or other parts of the plant, including the leaves, bark, root and stems, as they contain a chemical known as cyanogenic glycoside. This chemical can release cyanide into the body in some circumstances, such as chewing parts of the raw plant, resulting in nausea, diarrhoea and vomiting. This is a toxin also found in apricot seeds. Generally, commercial preparations and cooked elderberries don’t contain cyanide, so they don’t cause adverse reactions when used at recommended dosages.

Potential drug interactions

Because of its powerful effects on health and the immune system, the prolonged use of elderberry could potentially interact with several medications. If you currently take any medications, including the following, you should talk to your health care provider before using an elderberry supplement or any other elder plant products:

  • Diabetes medications
  • Diuretics (water pills)
  • Chemotherapy
  • Immunosuppressants, including corticosteroids, and medications used to treat autoimmune diseases
  • Laxatives
  • Respiratory medication 

Elderberry supplements

There are several forms of elderberry supplements, including gummies, lozenges, syrups and teas, but the most popular and best way to consume elderberry is in liquid form.

Using this antiviral herb is not recommended for women who are pregnant or breastfeeding, children, those with autoimmune disorders or people with organ transplants. If you have any other ongoing health concerns, talk with your health care provider before taking elderberry supplements.

Elderberry appears to have few side effects when used properly for short periods of time and following the dosage instructions on the packaging. 

Summary

People have used elderberries for their potential health-supporting properties for many years, most commonly to fight colds and the flu. 

Evidence does support its use to reduce the length and severity of flu symptoms, as well as likely playing a role in supporting heart health, improving antioxidant status, diabetes management and a variety of anti-inflammatory effects.

While elderberry may help in many health conditions, it is not a cure-all and should not replace other health therapies or medication. Do not exceed the recommended dose and consume as part of a balanced diet.

References

  1. Anthocyanins and Human Health

  1. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers

  2. Pilot Clinical Study on a Proprietary Elderberry Extract 

  3. Health benefits of anthocyanins and molecular mechanisms

  4. Anthocyanin-rich black elderberry extract improves markers of HDL function and reduces aortic cholesterol in hyperlipidemic mice

  5. The beneficial effects on blood pressure, dyslipidemia and oxidative stress of Sambucus nigra extract associated with renin inhibitors

  6. The traditional plant treatment, Sambucus nigra (elder), exhibits insulin-like and insulin-releasing actions in vitro

  7. Bioactive properties of Sambucus nigra L. as a functional ingredient for food and pharmaceutical industry

  8. Elderberry and Elderflower Extracts, Phenolic Compounds, and Metabolites and Their Effect on Complement, RAW 264.7 Macrophages and Dendritic Cells

  9. Herbal medicines as diuretics

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